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In June, 2018 the U.S. Food and Drug Administration (FDA) approved Epidiolex (cannabidiol)
for the treatment of two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome.1 (https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm611046.htm)
Epidiolex – purified CBD extracted from marijuana – is currently available as a prescription drug in the United States. The anti-convulsant effects of CBD are not confined to these rare forms of epilepsy, however, and the fact that CBD has been approved by the FDA to treat any seizure disorders is an indication of its promise in this area of medicine. For a full list of the medical conditions for which CBD may be useful, please consult our research page.
What we know about CBD & Epilepsy
The mechanisms by which CBD may reduce the frequency and severity of seizures are unclear. Initial investigations speculated that cannabinoid receptors (i.e. CB1 and CB2 receptors) were involved. More recent investigations suggest the mechanism may involve non-cannabinoid receptors, or may not involve receptors at all.2 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/)
Generally speaking, phyto and endocannabinoids are powerful regulators of neurological activity in the brain. The ECS protects the nervous system from hyperactivity during seizure events (Learn more about the endocannabinoid system).3 Endocannabinoids are produced during seizures and inhibit glutamate, an excitatory neurotransmitter, thus dampening seizure activity and reducing nerve cell death.4 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189640/) Phytocannabinoids are generally anticonvulsant and have been referred to as “circuit breakers” because of their ability to reduce seizures and corresponding neurodegeneration.3,4 (https://www.ncbi.nlm.nih.gov/pubmed/18776886, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189640)
The evidence base supporting the anti-convulsant effects of CBD is diverse and increasingly compelling. It ranges from anecdotal and observational reports by patient and healthcare providers5 (https://www.ncbi.nlm.nih.gov/pubmed/25845492) to pre-clinical studies involving animals to randomized controlled trials involving humans.6 (https://www.ncbi.nlm.nih.gov/pubmed/24854329) Two open-label studies and one double-blind, placebo-controlled trial showed meaningful reductions in seizure frequency and severity, specifically seizures associated with Dravet and Lennox-Gastaut syndromes (Median seizure frequency decreased by 40% in one of the open-label studies7 (https://www.ncbi.nlm.nih.gov/pubmed/26724101) and 53% in the placebo-controlled trial).8 (https://www.ncbi.nlm.nih.gov/pubmed/28538134) A 2018 systematic review and meta-analysis including four trials involving 550 patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) concluded that CBD contributed to a greater reduction in seizure frequency than conventional treatment alone.9 (https://www.ncbi.nlm.nih.gov/pubmed/30390221)
While researchers are still trying to understand the mechanism, CBD appears to offer meaningful reductions in seizures in patients suffering from epilepsy. The evidence base supporting the anti-convulsant effects of CBD is diverse and increasingly compelling – compelling enough for the FDA to approve purified CBD as a safe and effective treatment for certain seizure disorders.
Below is a list of available studies concerning the use of CBD, and other phytocannabinoids, in treating epilepsy.
Research and Case Studies on the effects of Cannabis to treat Epilepsy and Seizures:
- CBD for children with Dravet’s and intractable seizures(Video)
- Cannabis in Pediatrics
- Report of a parent survey of CBD-enriched cannabis use in pediatric treatment-resistant epilepsy
- Medicinal marijuana stops seizures, brings hope to a little girl
- Cannabinoids for epilepsy
- Cannabis, CBD, and epilepsy – From receptors to clinical response
- The non-psychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate and desensitize transient receptor potential vanilloid 1 (TRPV1) channels in vitro: potential for the treatment of neuronal hyperexcitability
- Chronic administration of CBDto healthy volunteers and epileptic patients
- Endocannabinoid system protects against cryptogenic seizures
- Seizing an opportunity for the endocannabinoid system
- Cannabidiol: promise and pitfalls
- Cannabidiol: Pharmacologyand potentialtherapeuticrolein epilepsyand otherneuropsychiatricdisorders
- Report of a parent survey of cannabidiol-enriched cannabis use in pediatrictreatment-resistant epilepsy
- From the Editors: Cannabidioland medicalmarijuanafor the treatmentof epilepsy
- Cannabidivarin (CBDV) suppressespentylenetetrazole (PTZ)-inducedincreases in epilepsy-related gene expression
- CBDexerts anti-convulsant effects in animal models of temporal lobe and partial seizures
- Cannabidiol displays antiepileptiform and antiseizure properties in vitro and in vivo
- Hypnotic and antiepileptic effects of CBD
- The cannabinoids as potential antiepileptics
- Cannabidiol–antiepileptic drug comparisons and interactions in experimentally induced seizures in rats
- CBDPost-Treatment Alleviates Rat Epileptic-Related Behaviors
- Pharmacology of cannabinoids in the treatment of epilepsy
- Therapeutic effects of cannabinoids in animal models of seizures, epilepsy, epileptogenesis, and epilepsy-related neuroprotection
- Report from a Survey of Parents Regarding the Use of Cannabidiol in Mexican Children with Refractory Epilepsy.
- Protective Effects of Cannabidiol against Seizures and Neuronal Death in a Rat Model of Mesial Temporal Lobe Epilepsy
- CBDTreatment for Refractory Seizures in Sturge-Weber Syndrome
- How do I find the right dosage of CBD for epilepsy and seizure-related disorders?
- What is CBD and how does it work?
- What is the endocannabinoid system and why it matters to your health?
What is Epilepsy?
Epilepsy is a neurological disorder characterized by recurrent surges of electrical activity in the brain, also known as seizures. These electrical impulses can spread throughout the muscular system, causing the patient to twitch/convulse. There are more than 40 different kinds of epilepsy that can cause over excitation of the neural activity in the brain.
While scientists still cannot explain the exact cause of these seizures, several risk factors have been recognized, these include:
Low oxygen to the brain during birth
Low sugar or sodium levels in the blood
Normally, epilepsy is treated using antiepileptic drugs (AEDs) that are designed to stop/control the electrical surge in the brain that causes seizures. These anticonvulsants include clonazepam, phenytoin, phenobarbital, primidone, valproic acid, and ethosuximide. Almost a third of all the patients diagnosed with epilepsy suffer from some kind of refractory epilepsy. Refractory epilepsy, also called intractable, uncontrolled or drug-resistant, are forms of seizures that do not respond even after the patient has completed two trials of different AED medication. Furthermore, most of these treatments come with numerous side effects including: nausea, hair loss, migraines, liver failure, weight gain, double vision, depression, insomnia, sedation, slurred speech, irritability, sedation and mood distortion.
Once the intractable status of the seizures has been established, alternative methods are usually considered, but even these have proven ineffective. As a result, the potential benefits of CBD in treating epilepsy could not come at a better time.
In the U.S. alone, 150,000 people are diagnosed with some form of epilepsy every year and as a matter of fact, one in every twenty-six people will experience a seizure episod eat some point in their lives.
By themselves, seizures are not harmful, however, they may cause other complications that threaten the well-being of the patient. Depending on what one is doing and where someone is when a seizure occurs, there is a great risk of lethal accidents occurring which makes it vital to prevent these convulsions. Considering that we spend $15.5 billion annually to combat this condition in America alone, we can use any help we get, and the use of CBD for epilespy looks promising.
1. Press Announcements – FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy [press release]. Office of the Commissioner2018.
2. Perucca E. Cannabinoids in the Treatment of Epilepsy: Hard Evidence at Last? J Epilepsy Res. 2017;7(2):61-76.
3. Katona I, Freund TF. Endocannabinoid signaling as a synaptic circuit breaker in neurological disease. Nat Med. 2008;14(9):923-930.
4. Alger BE. Seizing an Opportunity for the Endocannabinoid System. Epilepsy Curr. 2014;14(5):272-276.
5. Press CA, Knupp KG, Chapman KE. Parental reporting of response to oral cannabis extracts for treatment of refractory epilepsy. Epilepsy & behavior : E&B. 2015;45:49-52.
6. Devinsky O, Cilio MR, Cross H, et al. Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. 2014;55(6):791-802.
7. Devinsky O, Marsh E, Friedman D, et al. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. The Lancet Neurology. 2016;15(3):270-278.
8. Devinsky O, Cross JH, Laux L, et al. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017.
9. Lattanzi S, Brigo F, Trinka E, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs. 2018;78(17):1791-1804.
Chief Medical Advisor at Green Flower BotanicalsDr. Jamie Corroon, ND, MPH is the founder and Medical Director of the Center for Medical Cannabis Education, and Chief Medical Advisor at Green Flower Botanicals. Dr. Corroon is a licensed Naturopathic Doctor, peer-reviewed clinical researcher and industry consultant with a focus on medical Cannabis. He has completed certification programs from both the Society of Cannabis Clinicians and the American Academy of Cannabinoid Medicine. He is a member of both organizations and serves on the Research committee for the SCC. Dr. Corroon is committed to investigating the important clinical and public health questions resulting from the broadening acceptance of Cannabis in society. He lives in San Diego, California.
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This page has been submitted in cooperation with our Medical Advisor, Dr. Jamie Corroon. Dr. Corroon has reviewed and approved the information contained on this page for general accuracy, authenticity, and relevancy of the stated research. While it is our intent to publish the most up-to-date research available, this review is limited to the material submitted on this page and does not take into account research which may currently exist or supersede this content. This review is for informational purposes only and does not constitute the practice of medicine. CBD products are not approved by the FDA for the diagnosis, cure, mitigation, treatment, or prevention of any disease. You should always seek the advice of your physician before adding any supplement to your diet.
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